Nursing home quality scorecards should account for dementia care, researchers argue

Government agencies that rate nursing home quality should update their scoring system to account for the degree of cognitive impairment in facilities, along with the presence of specialized dementia units, according to a study in the November 2011 issue of the Journal of the American Medical Directors Association.

Poor ratings may cause facilities most experienced with dementia care to be overlooked or rejected by families seeking placement for a relative who needs these services, argue the researchers from Indiana University School of Medicine and the Regenstrief Institute.

For example, a low score can be given for a person’s worsening behavioral or psychological symptoms associated with cognitive impairment, even if that decline is due to the natural progression of the disease and not necessarily because quality of care is poor, according to the study.

“Since quality measures for dementia behaviors are not appropriately evaluated, that throws the entire rating system off,” researchers said. “The scoring system for nursing homes doesn’t accurately evaluate the quality of care provided to individuals with dementia, and it needs to be changed.”

In addition to looking at scorecards, the researchers suggest families also investigate a facility’s patient-to-staff ratio; whether prompt quality medical care is available to residents when needed; cleanliness of the facility; and proximity to family members who may visit. They are “strongly” against people relying solely on the Five-Star Ratings.